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EP0797962B2 - Areal implant - Google Patents

Areal implant Download PDF

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Publication number
EP0797962B2
EP0797962B2 EP97250072A EP97250072A EP0797962B2 EP 0797962 B2 EP0797962 B2 EP 0797962B2 EP 97250072 A EP97250072 A EP 97250072A EP 97250072 A EP97250072 A EP 97250072A EP 0797962 B2 EP0797962 B2 EP 0797962B2
Authority
EP
European Patent Office
Prior art keywords
plunger
basic structure
implant according
areal
knitted fabric
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP97250072A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP0797962B1 (en
EP0797962A3 (en
EP0797962A2 (en
Inventor
Bernhard Dr. Hinsch
Christian Dr. Walther
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Johnson and Johnson Medical GmbH
Original Assignee
Johnson and Johnson Medical GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
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Application filed by Johnson and Johnson Medical GmbH filed Critical Johnson and Johnson Medical GmbH
Publication of EP0797962A2 publication Critical patent/EP0797962A2/en
Publication of EP0797962A3 publication Critical patent/EP0797962A3/en
Publication of EP0797962B1 publication Critical patent/EP0797962B1/en
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Classifications

    • D—TEXTILES; PAPER
    • D04—BRAIDING; LACE-MAKING; KNITTING; TRIMMINGS; NON-WOVEN FABRICS
    • D04B—KNITTING
    • D04B21/00—Warp knitting processes for the production of fabrics or articles not dependent on the use of particular machines; Fabrics or articles defined by such processes
    • D04B21/10—Open-work fabrics
    • D04B21/12—Open-work fabrics characterised by thread material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/148—Materials at least partially resorbable by the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0068—Implantable repair or support meshes, e.g. hernia meshes having a special mesh pattern
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
    • D—TEXTILES; PAPER
    • D10—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
    • D10B2509/00—Medical; Hygiene
    • D10B2509/08—Hernia repair mesh

Definitions

  • the invention relates to an areal implant, in particular for abdominal wall closure.
  • the known implant nets have some disadvantages. For example, they are relatively heavy, i.e. the areal weight is as a rule more than 50 g/m 2 and predominantly even ca. 100 g/m 2 . If the implants are not resorbable, a relatively large quantity of foreign substance thus remains permanently in the body. In terms of tearing strength, the known implant nets are frequently over-sized, i.e. they have a much higher strength than is required from a physiological viewpoint. These properties, combined with the usual, net-like construction of the basic structure of the previously known implants, can mean that the well-being and the mobility of a patient who is fitted with such an implant are limited.
  • DE 38 30 005 C discloses a conventional areal implant made from resorbable materials having different melting points, in which knitted or woven fabric is heated to a temperature above the lowest, but below the highest melting point of the constituents.
  • This implant is porous and can be easily handled, but generally is not very flexible.
  • the areal implant according to the invention has a flexible basic structure made from a knitted fabric comprising non-resorbable material or resorbable material or a combination of such materials. If resorbable material is used, the resorption time (i.e. the period after which the total mass of the implant has degraded in vivo) is at least 60 days, and/or the in vivo decrease in strength is so slow that 30 days after implantation the tearing strength is still at least 10 % of the initial tearing strength. Non-resorbable or slowly resorbable materials are used in order that the basic structure is stable in the longer term and a more certain healing success can be ensured.
  • knit fabric is to be understood here in the widest sense. It also includes, for example, knits and other mesh structures, i.e. essentially all textile materials which are not pure woven fabrics.
  • the knitted fabric of the basic structure is designed to stretch more than the tissue region destined to receive the implant below a critical force and stretch less than this tissue region above the critical force.
  • the critical force is below the highest load this tissue region can be submitted to.
  • the flexible basic structure is thereby matched without problems to the usual movements of the tissue (e.g. of an abdominal wall) into which the areal implant is inserted or sewn.
  • the tissue e.g. of an abdominal wall
  • the elasticity behaviour of the system consisting of an abdominal wall and the inserted implant is shaped by the abdominal wall.
  • the implant thus does not act as a foreign body. If, on the other hand, the forces exceed the critical force, the implant absorbs the forces and thus prevents injury to the body tissue, e.g. the abdominal wall.
  • the basic structure is stiffened by a synthetic resorbable material whose resorption time is less than that of the basic structure and preferably lies in the range from 2 days to 200 days.
  • the areal implant is relatively firm and easy to handle during the operation (e.g. when cutting to size and inserting) but loses its then undesired rigidity after a relatively short time in the body tissue, because the stiffening synthetic material is resorbed.
  • the knitted fabric of the basic structure is constructed in such a way that it has stress/strain properties which can be quantified using a plunger pressing test, as stated in claim 2.
  • the areal weight of the basic structure is preferably less than 50 g/m 2 .
  • suitable materials are used (see below), for an implant for abdominal wall closure of correspondingly low mass, a strength can be achieved which lies above the physiological framework data given by Klinge ( U. Klinge, B. Kleinhalten, W. Limberg, A.P. bttinger, V. Schumpelick: Use of mesh materials in scar rupture; Change in the abdominal wall dynamics after mesh implantation; Poster, 162nd Convention of the Lower Rhine-Westphalian Surgeon's Association, 1995 ).
  • the intra-abdominal pressure is 20 kPa (150 mm Hg) at most, the wall stress at the edge of an abdominal tissue region 16 N/cm at most and the tearing strength of the fasciae, 20 N/cm to 30 N/cm.
  • An implant constructed in this way is thus able to absorb all forces occurring physiologically at a healthy abdominal wall and also offers an additional safety reserve. More stable and thus heavier basic structures offer no additional advantage, but can have the disadvantage of undesired rigidity mentioned at the beginning.
  • the knitted fabric of the basic structure preferably has an approximate rectangular structure or approximate quadratic structure knitted from yarns.
  • Honeycomb structures or structures with approximately circular openings or other polygonal structures are however also conceivable.
  • Preferred versions of such knitted fabrics are explained in more detail in the description of the embodiments with the help of figures.
  • the desired stress/strain behaviour can be achieved with knitted structures of this type, i.e. the basic structure stretches more than the tissue region destined to receive the implant below the critical force and less than this tissue region above the critical force, the critical force being below the highest load allowable for this tissue region.
  • the stiffening material can e.g. have resorbable yarns or thin monofilaments woven into the basic structure, it can have a film which is applied to one side or both sides of the basic structure, or it can have a coating applied to the material of the knitted fabric. Combinations of these are also conceivable.
  • Advantageous materials for the basic structure are e.g. polypropylene, polyester, polyglactin 910, polylactide yarns, polyglycolide yarns, poly-p-dioxanone yarns, but also copolymers, mixtures or combinations of such materials.
  • Suitable as the stiffening material are e.g. yarns or films of poly-p-dioxanone, yarns or films of polyglactin (i.e. glycolide/lactide copolymers), yarns or films of polylactide, yarns or films of other copolymers of these materials, monofilaments of such materials (e.g. with thread thicknesses of 0.01 mm to 0.2 mm in diameter), coating waxes made from such materials, in particular from polyglactin 630, and others.
  • Mixtures of synthetic resorbable materials whose resorption time lies in the desired range can also be used for the stiffening material. If the stiffening material is of a textile nature, the result of the in vivo decrease in strength is that, after an implantation time of typically 2 to 50 days, the residual tearing strength is still about 10 % of the initial tearing strength.
  • the material of the basic structure is preferably not dyed, in order that the basic structure, which does after all remain in the body for a long time or permanently after implantation, shows no undesired foreign body reaction as a result of the dye.
  • the stiffening material is dyed. This does in fact permit a better visual check on the implant during the operation. During resorption the dye disappears, so that no dye remains in the body in the longer term and thus no undesired side-effects occur.
  • Figures 1 to 5 show magnified schematic views of different versions of the knitted fabric of the flexible basic structure of the areal implant according to the invention.
  • the figures are drawn on the basis of scanning electron microscope photographs taken at roughly 25 times magnification.
  • Variant A of the knitted fabric according to Figure 1 has an approximate quadratic structure, the crosspiece length being about 3 mm in each case.
  • Variant B of the knitted fabric according to Figure 2 also has an approximate quadratic structure. However, the crosspiece length is larger here and is about 5 mm.
  • Variant C of the knitted fabric, shown in Figure 3 has differently sized openings or pores, the area of the large pores being greater than 0.5 mm 2 and that of the smaller pores being less than 0.5 mm 2 .
  • Variants D and E of the knitted fabric, shown in Figures 4 and 5 have other structures.
  • Filament multifilament multifilament multifilament multifilament multifilament multifilament monofilament Thread systems 3 3 3 3 3 1 Number of courses per cm (longitudinal) 220 220 160 186 212 62 Number of wales per cm (transverse) 52 38 57 64 72 46 Yarn fineness in tex [g/1000 m] 6.7 6.7 6.7 6.7 6.7 20.6 Pore size (approx.) of the pores > 0.5 mm 2 [mm 2 ] 3 x 3 4 x 4 1.3 x 1.3 2 x 3.3 1.3 x 3.3 Proportion of pores [%] 93 95 83.5 Thickness [mm] 0.41 0.4 0.7 Areal weight [g/m 2 ] 26.8 20.1 31.4 36.2 40 109 Seam tear-out force per cm (longitudinal) [N/cm] 17.5 13.5 20.1 20.7 23 57 Seam tear-out force per cm (transverse) [N/cm] 22.7 22.4
  • Table 1 Given in Table 1 are data for the individual variants A to E of the flexible basic structure of the areal implant according to the invention and, for comparison, the corresponding data for a conventional implant net.
  • Variants A to E are all knitted from multifilament polypropylene, using three thread systems.
  • the conventional implant net consists of monofilament polypropylene, using one thread system.
  • Table 1 shows the number of courses per centimetre, the number of wales per centimetre, the yarn fineness, the dimensions of the pores larger than 0.5 mm 2 , the proportion of pores (relative to the total area of the knitted fabric or of the conventional implant net) and the thickness.
  • variants A and B have a larger proportion of pores and a smaller thickness.
  • variants A to E have a relatively low areal weight, which in all cases is below 50 g/m 2 and is thus clearly smaller than that of the conventional implant net.
  • the seam tear-out force per centimetre of seam length, measured along and across the knitted fabric or the conventional implant net, is as a rule more than 16 N/cm, the value quoted by Klinge for the maximum wall stress at the edge of an abdominal tissue region.
  • the stress-strain behaviour of the knitted fabrics or of the conventional implant net can be best described quantitatively using a plunger pressing test related to DIN 54307.
  • material properties related to area are measured with such plunger pressing tests.
  • Figure 6 shows a schematic view of a device for carrying out plunger pressing tests.
  • a semispherical plunger 1, which is attached to a shank 2, is moved in the direction of the arrow, i.e. along the axis of symmetry.
  • a sample 5 of the knitted fabric to be investigated or of a conventional implant net is clamped between an upper ring 3 and a lower ring 4.
  • the plunger 1 When the plunger 1 is advanced in a downwards direction, it pushes the sample 5 in a downwards direction. The greater the deformation of the sample 5, the greater the force F exerted on the plunger 1 by the sample 5 becomes.
  • the plunger radius is 50 mm.
  • the internal radius of the upper ring 3 and of the lower ring 4 is 56.4 mm, so that the effective surface area of the sample 5 is 100 cm 2 .
  • the deformation given in Table 1 arises which results from the change in length of the sample at r contact measured in the peripheral direction, relative to the corresponding peripheral length of the non-deformed sample. From the test data, it is also possible to calculate the elongation at break, also given in Table 1, which is higher than the deformation since the sample in the plunger pressing test tears, not at r contact , but in the middle region where it is more stretched than at r contact .
  • Table 1 also shows the results of a strip tensile test carried out on samples of variants A to E and the conventional implant net. For this, the tearing force per centimetre of sample width (tearing strength) along the sample direction and the elongation at break are determined. It is, however, to be taken into consideration here that the values can be severely distorted by the test (contraction upon drawing), making the plunger pressing test more informative.
  • the tearing strengths lie in the range from 25 to 45 N/cm and are therefore at least as large as the tearing strength of the fasciae quoted by Klinge (20 to 30 N/cm). The much higher tearing strength of the conventional implant net is again not necessary.
  • Figure 7 shows a complete plunger force - plunger path length diagram, determined using a plunger pressing test, for the knitted fabric of variant B compared with the conventional implant net made of polypropylene (H).
  • the plunger force - plunger path length diagrams as in Figure 7 can be converted into force-length change diagrams or into stress-strain diagrams. In the case of the latter, stress is to be understood as the force per centimetre of sample width.
  • Figure 8 shows such a stress - strain diagram of the flexible basic structure according to variant A, as results from the plunger pressing test.
  • a stress - strain diagram determined using rat musculature is also shown, which was not, however, obtained by a plunger pressing test, which was not possible to carry out with rat musculature because of the sample size required, but on the basis of a strip tensile test on a sample strip approx. 1 cm in width. Measurements on the rat musculature were taken at a musculature thickness which corresponds approximately to that of a human abdominal wall, wherein the spread, as in the case of any biological sample, can be correspondingly large.
  • the forces required for variant A are smaller than for rat musculature, and for elongations of less than 50 %, even much smaller.
  • a knitted fabric according to variant A implanted into muscle stretches with it during usual movements, without appreciable forces being necessary for this. Therefore, the implant does not have an inconvenient effect.
  • the knitted fabric of the basic structure undergoes less pronounced further stretching than the tissue, so that the knitted fabric of the basic structure is able to absorb the forces.
  • the transition between the two elongation or stretching regions takes place at a critical force which results from the point of intersection of the curves in Figure 8 .
  • the critical force defined in this way should be below the highest load which is allowable for the tissue region.
  • Table 2 shows the plunger forces F measured in the plunger pressing test as a function of the plunger path length s for variants A to E, i.e. values as are shown graphically in Figure 7 for variant B.
  • the values for the conventional implant net made of polypropylene (H) according to Table 1 and for another conventional implant net made of polyester (M) are also listed.
  • the data for F max and for the plunger path length at F max are taken from Table 1. In the plunger pressing test initial damage to the investigated sample takes place at F max .
  • F max is much larger for the conventional implant net made of polypropylene than for variants A to E.
  • F max for the conventional implant net made of polyester is of the same order of magnitude as for variants A to E.
  • the plunger force for variants A to E is much smaller than for the conventional implant net made of polyester, which again illustrates the superiority of the implant according to the invention.
  • the force was not returned to zero in the plunger pressing tests (as in Figure 9 ), but operated at a residual force of 0.5 N.
  • variant B of the flexible basic structure of the implant according to the invention offers a clearly lower resistance to the alternating load, which is to simulate the movement of an abdominal wall, than do the conventional implant nets.
  • Figure 10 shows a magnified schematic view of the flexible basic structure according to variant A, into which a multifilament thread made of polyglactin 910 is woven for stiffening.
  • Figure 11 Shown in Figure 11 is a magnified schematic view of the flexible basic structure according to variant B which is provided with a coating of polyglactin 630.
  • Polyglactin 630 is a copolymer of glycolide and lactide in the ratio 6:3 and, just like polyglactin 910, is resorbable.
  • the flexible basic structure is stiffened by the woven-in thread or by the coating, as a result of which handling of the implant according to the invention during use, in particular during the operation, is much improved. Since the stiffening material is resorbable, the rigidity of the implant in the body of the patient decreases with time, until the implant has achieved the properties of the basic structure with its favourable stress/strain behaviour, as explained earlier.
  • Table 4 compares the bending resistances of the knitted fabric according to variant A ( Figure 1 ), of the knitted fabric according to variant B ( Figure 2 ), of the knitted fabric according to variant A with stiffening thread ( Figure 10 ), of the knitted fabric according to variant B with stiffening coating ( Figure 11 ) and of a conventional implant net made of polypropylene.
  • the bending resistances quoted were determined in a three-point bending test with the supports 15 mm apart and a sample width of 15 mm.
  • the conventional implant rated as good by users as regards handling, has a bending resistance of ca. 0.15 to 0.20 N/mm.
  • the bending resistances of the stiffened knitted fabrics are clearly higher than those of the original basic structures and are between ca. 0.05 and 0.42 N/mm.
  • the initial rigidity of the areal implant according to the invention can be varied within wide limits by means of the type, the quantity and the structure of the applied or incorporated stiffening resorbable material.

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  • Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Epidemiology (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Chemical & Material Sciences (AREA)
  • Textile Engineering (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Biomedical Technology (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)
EP97250072A 1996-03-26 1997-03-13 Areal implant Expired - Lifetime EP0797962B2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19613730A DE19613730C2 (de) 1996-03-26 1996-03-26 Flächiges Implantat zum Verstärken oder Verschließen von Körpergewebe
DE19613730 1996-03-26

Publications (4)

Publication Number Publication Date
EP0797962A2 EP0797962A2 (en) 1997-10-01
EP0797962A3 EP0797962A3 (en) 1997-11-05
EP0797962B1 EP0797962B1 (en) 2004-05-12
EP0797962B2 true EP0797962B2 (en) 2009-09-02

Family

ID=7790607

Family Applications (1)

Application Number Title Priority Date Filing Date
EP97250072A Expired - Lifetime EP0797962B2 (en) 1996-03-26 1997-03-13 Areal implant

Country Status (9)

Country Link
US (1) US6162962A (ja)
EP (1) EP0797962B2 (ja)
JP (1) JP4450437B2 (ja)
CN (1) CN1163196C (ja)
AU (1) AU704334B2 (ja)
BR (1) BR9701466B8 (ja)
CA (1) CA2200801C (ja)
DE (2) DE19613730C2 (ja)
ZA (1) ZA972563B (ja)

Cited By (9)

* Cited by examiner, † Cited by third party
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US8083755B2 (en) 2006-06-22 2011-12-27 Novus Scientific Pte. Ltd. Mesh implant for use in reconstruction of soft tissue defects
US8118727B2 (en) 2000-10-12 2012-02-21 Coloplast A/S Method for supporting pelvic anatomy
US8128554B2 (en) 2000-10-12 2012-03-06 Coloplast A/S System for introducing a pelvic implant
US8157821B2 (en) 2001-03-30 2012-04-17 Coloplast A/S Surgical implant
US8215310B2 (en) 2004-05-21 2012-07-10 Coloplast A/S Implant for treatment of vaginal and/or uterine prolapse
US8668635B2 (en) 2000-10-12 2014-03-11 Coloplast A/S Pelvic implant with suspending system
US8920304B2 (en) 2000-07-05 2014-12-30 Coloplast A/S Method and device for treating urinary incontinence
US9005222B2 (en) 2002-08-02 2015-04-14 Coloplast A/S Self-anchoring sling and introducer system
US9186489B2 (en) 2003-03-27 2015-11-17 Coloplast A/S Implantable delivery device system for delivery of a medicament to a bladder

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* Cited by examiner, † Cited by third party
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FR2732582B1 (fr) * 1995-04-04 1997-10-17 Sgro Jean Claude Element prothetique parietal
US7238403B2 (en) * 1997-03-07 2007-07-03 Kx Industries, Lp Composite for removing moisture, liquid and odors with anti-microbial capability
US5980564A (en) * 1997-08-01 1999-11-09 Schneider (Usa) Inc. Bioabsorbable implantable endoprosthesis with reservoir
FR2766698B1 (fr) 1997-08-01 1999-11-05 Cogent Sarl Tissu prothetique tridimensionnel ajoure
FR2767671B1 (fr) 1997-08-27 1999-11-26 Ethnor Dispositif obturateur prothetique pour l'obturation de canaux herniaires
US6241768B1 (en) 1997-08-27 2001-06-05 Ethicon, Inc. Prosthetic device for the repair of a hernia
FR2767672B1 (fr) * 1997-08-27 1999-11-26 Ethnor Protheses pour l'obturation de canaux herniaires
US6319264B1 (en) 1998-04-03 2001-11-20 Bionx Implants Oy Hernia mesh
US6740122B1 (en) 1998-09-11 2004-05-25 C. R. Bard, Inc. Preformed curved prosthesis that is adapted to the external iliac vessels
US6723133B1 (en) 1998-09-11 2004-04-20 C. R. Bard, Inc. Performed curved prosthesis having a reduced incidence of developing wrinkles or folds
DE19906172C1 (de) * 1999-02-08 2000-07-13 Ethicon Gmbh Resorbierbares Implantat
DE19912360A1 (de) * 1999-03-19 2000-09-21 Aesculap Ag & Co Kg Strangförmiges Implantat aus resorbierbarem Polymermaterial, Verfahren zu seiner Herstellung und Anwendung in der Chirurgie
DE19942611C1 (de) 1999-08-31 2001-07-05 Ethicon Gmbh Verstärktes flächiges Implantat
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CN1169277A (zh) 1998-01-07
US6162962A (en) 2000-12-19
CA2200801A1 (en) 1997-09-26
BR9701466B8 (pt) 2021-06-22
DE69729021D1 (de) 2004-06-17
AU1648597A (en) 1997-10-02
DE69729021T3 (de) 2009-12-03
JP4450437B2 (ja) 2010-04-14
ZA972563B (en) 1998-09-25
EP0797962B1 (en) 2004-05-12
JPH1024054A (ja) 1998-01-27
AU704334B2 (en) 1999-04-22
CA2200801C (en) 2005-12-13
EP0797962A3 (en) 1997-11-05
DE19613730C2 (de) 2002-08-14
MX9702257A (es) 1998-03-31
BR9701466A (pt) 1998-11-10
DE19613730A1 (de) 1997-10-02
CN1163196C (zh) 2004-08-25
EP0797962A2 (en) 1997-10-01
DE69729021T2 (de) 2004-09-09
BR9701466B1 (pt) 2011-10-18

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